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创伤性脊髓损伤所致神经源性膀胱患者自我管理能力现状及相关影响因素分析

Analysis of the current status of self-management ability and related influencing factors in patients with neurogenic bladder due to traumatic spinal cord injury.

作者信息

Zhang Yanyan, Wei Yanxin, Li Shijiao, Sun Jingni, Ding Yunmei, Chang Tongmin, Zhang Yurong, Zhang Yuan, Lu Ming

机构信息

Clinical Epidemiology Unit, Qilu Hospital of Shandong University, 107 Wenhuaxi Road, Jinan, Shandong, 250012, China.

Medical Affairs Department, Qilu Hospital of Shandong University, Jinan, Shandong, China.

出版信息

World J Urol. 2025 May 4;43(1):264. doi: 10.1007/s00345-025-05521-8.

Abstract

OBJECTIVE

This study aims to assess the current status of self-management ability in patients with neurogenic bladder resulting from traumatic spinal cord injury (TSCI) and to analyze the factors influencing this ability.

METHOD

A cross-sectional study was conducted from November 2023 to July 2024, a total of 305 patients with neurogenic bladder due to TSCI were recruited from over 30 medical institutions, including rehabilitation centers within tertiary general hospitals, secondary rehabilitation hospitals, and private rehabilitation facilities across Shandong Province, China. Face-to-face interviews were conducted using a general information questionnaire, the patient positive measurement scale, the social support rating scale, and the self-management ability scale. Pearson correlation analysis and multiple linear regression were employed for statistical analysis.

RESULTS

Among 305 patients with neurogenic bladder caused by TSCI, the score of positivemeasurement scale was 40.95 ± 8.26, the score of the social support scale was 38.12 ± 8.35, and the score of self-management ability scale was 118.19 ± 37.16. In univariate analysis, social support (β = 0.364, P < 0.001), positive degree (β = 0.505, P < 0.001) and bladder training (β = -0.349, P < 0.001) positively predicted self-management ability. Age was a negative predictor of self-management ability (β = -0.204, P < 0.001). In multiple linear regression analysis, social support (β = 0.194, P < 0.001), bladder training (β = -0.262, P < 0.001) and positive degree (β = 0.376, P < 0.001) were still positively correlated with self-management ability.

CONCLUSION

Self-management ability in patients with neurogenic bladder secondary to TSCI is moderate, and patient activation is low. The establishment of an effective social support system, the implementation of bladder training and the improvement of patients positive degree can be used as an entry point to improve their self-management behavior ability, so as to reduce the patients' dependence on others care and prepare for discharge and return to society.

CLINICAL TRIAL NUMBER

Not applicable.

摘要

目的

本研究旨在评估创伤性脊髓损伤(TSCI)所致神经源性膀胱患者的自我管理能力现状,并分析影响该能力的因素。

方法

于2023年11月至2024年7月进行一项横断面研究,从中国山东省30多家医疗机构招募了305例因TSCI导致神经源性膀胱的患者,这些医疗机构包括三级综合医院的康复中心、二级康复医院和私立康复机构。采用一般信息问卷、患者积极度量表、社会支持评定量表和自我管理能力量表进行面对面访谈。采用Pearson相关分析和多元线性回归进行统计分析。

结果

在305例因TSCI导致神经源性膀胱的患者中,积极度量表得分40.95±8.26,社会支持量表得分38.12±8.35,自我管理能力量表得分118.19±37.16。单因素分析中,社会支持(β=0.364,P<0.001)、积极程度(β=0.505,P<0.001)和膀胱训练(β=-0.349,P<0.001)对自我管理能力有正向预测作用。年龄是自我管理能力的负向预测因素(β=-0.204,P<0.001)。多元线性回归分析中,社会支持(β=0.194,P<0.001)、膀胱训练(β=-0.262,P<0.001)和积极程度(β=0.376,P<0.001)仍与自我管理能力呈正相关。

结论

TSCI继发神经源性膀胱患者的自我管理能力中等,患者积极性较低。建立有效的社会支持系统、实施膀胱训练和提高患者积极程度可作为改善其自我管理行为能力的切入点,从而减少患者对他人护理的依赖,为出院和回归社会做好准备。

临床试验编号

不适用。

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